3.0T磁共振波谱成像联合扩散张量成像对小儿髓母细胞瘤的相关分析

Correlation analysis of 3.0T magnetic resonance spectroscopy combined with diffusion tensor imaging in children with medulloblastoma

目的探讨3.0 T磁共振氢质子波谱成像(~1H-magnetic resonance spectroscopy,~1H-MRS)联合扩散张量成像(diffusion tensor imaging,DTI)应用于小儿髓母细胞瘤(medulloblastoma,MB)的价值。材料与方法回顾性分析21例经病理证实的MB的患儿及年龄匹配健康对照组~1H-MRS和DTI检查,分别观察MRS波谱图各代谢物信息、表观扩散系数(apparent dispersion coefficient,ADC)、部分各向异性(fractional anisotropy,FA)及扩散张量纤维束成像(diffusion tensor tractography,DTT)的变化。分别分析肿瘤中心、肿瘤周边、健康对照组N-乙酰天冬氨酸(N-acetylaspartic acid,NAA)、肌酸(creatine,Cr)、胆碱(choline,Cho)及Cho/Cr、NAA/Cr、Cho/NAA、ADC值、FA值的差异。结果21例MB肿瘤发生在小脑蚓部(11/21)、第四脑室内(7/21)及右侧小脑半球(3/21);男/女(13/8),男患儿发病年龄小,平均(28.20±22.24)个月,女患儿发病年龄平均(37.37±21.86)个月;男患儿肿瘤平均体积小(75.30±52.42)cm^(3),女患儿肿瘤平均体积(86.72±49.41)cm^(3)。~1H-MRS显示肿瘤中心Cho波峰抬高,NAA峰下降,NAA/Cr下降、Cho/Cr升高;DTI数据中肿瘤中心ADC值低,FA值高,DTT上纤维束纤细紊乱,并且肿瘤区纤维束局部连续性中断、推移。结论~1H-MRS联合DTI对MB显示有一致性,不同原理给出一致性结果,在不同的细胞及分子水平为临床提供更精准的病变范围及为手术方式提供帮助。

Objective:To investigate the value of~1H-magnetic resonance spectroscopy(MRS)combined with diffusion tensor imaging(DTI)in the treatment of medulloblastoma(MB)in children.Materials and Methods:Twenty-one patients with MB confirmed by pathology were examined by~1H-MRS and DTI.The changes of metabolite information,ADC,FA and DTT were observed.The differences of N-acetylaspartic acid(NAA),creatine(Cr),choline(Cho),NAA/Cr,Cho/Cr,Cho/NAA,apparent diffusion coefficient(ADC)and fractional anisotropy(FA)in tumor center,tumor periphery and normal tissues were analyzed.Results:In 21 cases of MB,the tumors occurred in the vermis(11/21),the fourth ventricle(7/21)and the right cerebellar hemisphere(3/21),male/female(13/8),the average age of onset was(28.20±22.24)months in male,(37.37±21.86)months in female,(75.30±52.42)cm^(3) in male and(86.72±49.41)cm^(3) in female.MRS showed that the peak Cho wave increased,the peak of NAA decreased,the peak of NAA/Cr decreased,the peak of Cho/Cr increased;in DTI data,the ADC value of tumor center was low,the FA value was high,DTT showed that the fiber bundle was fine and disordered,and the local continuity of the fiber bundle in the tumor area was interrupted and pushed.Conclusions:~1H-MRS and DTI are consistent in MB display,and different principles give consistent results.At different cell and molecular levels,they can provide more accurate lesion range and help for operation.